tbuckley/cabot-search huggingface dataset:
Use of a novel re-openable endoclip for the closure of a large mucosal defect after endoscopic submucosal dissection
Authors: Daiki Kitagawa, Satoki Shichijo, James W. Li, Yuki Okubo, Yoji Takeuchi, Noriya Uedo
Journal: Endoscopy (2023)

A 71-year-old woman with a 100-mm granular type laterally spreading tumor of the sigmoid colon was referred to our hospital ([Fig. 1]). Endoscopic submucosal dissection (ESD) with en bloc resection of the tumor was performed in 89 min. The specimen measured 105 × 65 mm, and the post-ESD mucosal defect occupied more than three-quarter of the luminal circumference ([Video 1], [Fig. 2]). We closed the large mucosal defect along its long axis using a novel re-openable endoclip (Mantis Clip; Boston Scientific, Natick, Massachusetts, USA) to minimize adverse events and prevent stricture formation ([Fig. 3]).
Easier removal of a gastrointestinal stromal tumor using a new detachable snare-assisted traction technique
Authors: Zhang Tao, Jie Liu, Wen Feng Pu, Chao Lan, Ning Chuan Ren, Feng Ying Lin, Dan Hu
Journal: Endoscopy (2023)

A 51-year-old woman presented to our department with a stromal tumor (about 3 × 2 cm) in the gastric body ([Fig. 1]). After the tumor had been marked, mucosal and submucosal incision was commenced, but it was not possible to make an effective incision owing to the narrow gap between the tumor and the normal muscularis propria caused by the effect of gravity on the tumor ([Video 1]). A detachable snare was used to trap part of the tumor and a clip with a traction wire was used to clamp the detached snare to create traction. After traction had been applied via the detached snare, the incision gap was enlarged ([Fig. 2]) and the tumor was then rapidly excised by the now effective incision ([Fig. 3]). Pathologic examination showed that the tumor was a low risk gastrointestinal stromal tumor of 3 × 2 cm. Follow-up after 1 month showed that the wound had healed ([Fig. 4]).
Endoscopic submucosal dissection of a laterally spreading tumor totally invading a deep sigmoidal diverticulum using an adaptive traction strategy
Authors: Jean Grimaldi, Bertrand Napoléon, Louis-Jean Masgnaux, Sarah Leblanc, Jérôme Rivory, Vincent Lépilliez, Mathieu Pioche
Journal: Endoscopy (2023)

Endoscopic resection of colonic lesions invading diverticula is technically challenging due to the absence of an underlying muscle layer. It has been shown that the endoscopic mucosal resection (EMR) technique is associated with significant risks of perforation and failure for diverticular lesions [1]. The endoscopic submucosal dissection (ESD) technique with traction strategy seems to be associated with more promising results for shallow diverticula (< 6 mm) [2]. However, for deeper diverticula, incomplete resection rates are high owing to the technical difficulty, and only few previous successes have been described for these lesions [3].
Diverticular peroral endoscopic myotomy: management of a complex epiphrenic diverticulum
Authors: Abdelazeez Gaber, Ismail Fadloon, Hany Shehab
Journal: Endoscopy (2023)

Epiphrenic diverticula are a rare entity presenting with dysphagia and vomiting in most cases. Conventional treatment usually involves complex thoracic surgeries with considerable morbidity, especially as the condition usually affects elderly patients. The overall mortality rate for surgical management of epiphrenic diverticula is about 5 %, with morbidity rate as high as 20 % [1]. A few case reports and case series have shown successful endoscopic management of epiphrenic diverticula by endoscopic septotomy (DPOEM) [2] [3]. In this video we describe a case of a large complex epiphrenic diverticulum in a 78-year-old man presenting with long-standing dysphagia and vomiting ([Video 1]).
A novel method for intratunnel closure of mucosal injuries during peroral endoscopic myotomy using standard endoclips
Authors: Ahmad Madkour, Amr Elfouly, Osama Elnahas, Sara Moreed, Hassan Atalla
Journal: Endoscopy (2023)

Mucosal perforations, reported in 4.2 %–17.3 % of cases [1], are one of the major inadvertent complications of peroral endoscopic myotomy. Mostly, mucosal perforations occur at the gastroesophageal junction (GEJ), where the muscularis propria and mucosal layers are in close proximity, representing major challenges for endoscopic management [2]. This is largely related to the constrained position of the endoscope and the challenge of controlling the direction of the endoclips, particularly when using the retroflexed view below the cardia. Over-the-scope clips [3], endosutures [4], fibrin sealant [1], and even diluted cyanoacrylate [5] have been reported as being used in such situations, yet they are not usually available and their costs are high.
Cholangioscopy-directed basket extraction of bile duct stones in a pregnant patient
Authors: Jordan Burlen, Anna Cecilia Amaral, Waleed K. Hussain, Samuel Han
Journal: Endoscopy (2023)

Gallstone-related disease and complications are common in pregnancy. Complications of gallstone disease are associated with increased mortality for both the patient and the fetus [1]. Endoscopic retrograde cholangiopancreatography (ERCP) offers a safe and effective treatment for biliary obstruction during pregnancy [2]. Though radiation exposure of ERCP is low, the long-term fetal effects of ERCP-related radiation exposure are unknown [3]. Given the advances in technology and devices for cholangioscopy, we describe an endoscopic technique for cholangioscopy-guided removal of bile duct stones in pregnant patients without the use of any fluoroscopy.
Use of a transparent cap with a slit facilitates endoscopic injection sclerotherapy of esophageal varices
Authors: Kuniyo Gomi, Hiroshi Takahashi, Erika Yoshida, Misako Tohata, Yorimasa Yamamoto, Masatsugu Nagahama
Journal: Endoscopy (2023)

Prophylactic treatment for bleeding is indicated for esophageal varices if the varices are F2 or greater, or if the red-color sign is positive [1] [2]. In Japan, endoscopic treatment is the first choice of treatment for bleeding esophageal varices. Endoscopic injection sclerotherapy (EIS) includes the "EO method," where 5 % ethanolamine oleate (EO) is injected intravascularly, and the "AS method," where 1 % aethoxysklerol is injected extravascularly. The EO method involves endoscopic varicealography during injection sclerotherapy, with the esophageal varices and their supply tracts being occluded under fluoroscopic guidance; however, endoscopic puncture of esophageal varices and the holding of the needle tip in the blood vessel require advanced techniques. Thin varices are difficult to puncture and, even after they are punctured successfully, respiratory fluctuations, esophageal peristalsis, and the patient's body movements can dislodge the needle. Therefore, we developed a transparent cap with a slit to facilitate puncture and needle fixation in this situation ([Fig. 1]).
Hydrophobic Polystyrene‐Modified Gelatin Enhances Fast Hemostasis and Tissue Regeneration in Traumatic Brain Injury
Authors: Wenyan Li, Kaige Xu, Yuqing Liu, Xuejiao Lei, Xufang Ru, Peiwen Guo, Hua Feng, Yujie Chen, Malcolm Xing
Journal: Advanced Healthcare Materials (2023)

Hemostatic sealant is required to deal with blood loss, especially in the scenario of traumatic brain injury (TBI), which presents high rates of morbidity and disability. Hemostasis in surgery with traditional gelatin-based sealants often leads to blood loss and other issues in brain because of the hydrophilic gelatin swelling. Herein, hydrophobic effects on the hemostasis in TBI surgery are studied by tuning the chain length of polystyrene (PS) onto methylacrylated gelatin (Gel-MA). The hydrophobicity and hemostatic efficiency can be tuned by controlling the length of PS groups. The platelet activation of modified sealants Gel-MA-2P, Gel-MA-P, and Gel-MA-0.5P is as much as 17.5, 9.1, and 2.1 times higher than Gel-MA in vitro. The hemostatic time of Gel-MA-2P, Gel-MA-P, and Gel-MA-0.5P groups is 2.0-, 1.6-, and 1.1-folds faster than that in Gel-MA group in TBI mice. Increased formation of fibrins and platelet aggregation can also be observed in vitro by scanning electron microscopy. Animal's mortality is lowered by 46%, neurologic deficiency is reduced by 1.5 times, and brain edema is attenuated by 10%. Protein expression is further investigated to exhibit toxic iron-related processes caused by delayed hemostasis and activation of platelets via PI3K/PKC-α signaling. The hydrophobic Gel-MA has the potential in hemostatic TBI and promotes nervous system recovery in brain with the potentials in clinics.
Endoscopic submucosal dissection of gastric neoplasms with severe fibrosis using a new thin-therapeutic endoscope and a dedicated conical cap
Authors: Yoshimasa Miura, Hisashi Fukuda, Takashi Ueno, Yoshikazu Hayashi, Hiroyuki Osawa, Alan Kawarai Lefor, Hironori Yamamoto
Journal: Endoscopy (2023)

Recently, endoscopic submucosal dissection (ESD) using the pocket-creation method (PCM) has been developed as a kind of third space endoscopy. PCM enables complete dissection under the lesion before making the circumferential incision [1]. Using this method, a wide submucosal space should be created with a small entrance where a small-diameter endoscope is more desirable.
Double soft-tipped guidewire facilitating the rendezvous technique for ERCP
Authors: Yoshihide Kanno, Haruka Okano, Fumisato Kozakai, Kento Hosokawa, Kei Ito
Journal: Endoscopy (2023)

The rendezvous technique has been a traditional salvage technique when transpapillary cannulation is difficult [1] [2]. For the rendezvous technique, a guidewire is inserted via a percutaneously or an endosonographically created route (endoscopic submucosal resection [ESR]) into the duodenum through the papilla and then caught under duodenoscopy to ensure transpapillary access from the duodenum. After successfully approaching the duct from the duodenum along the guidewire, the wire must be exchanged or inverted to use the seeking tip to seek upward ducts.
What Should ChatGPT Mean for Bioethics?
Authors: I. Glenn Cohen
Journal: The American Journal of Bioethics (2023)

In the last several months, several major disciplines have started their initial reckoning with what ChatGPT and other Large Language Models (LLMs) mean for them - law, medicine, business among other professions. With a heavy dose of humility, given how fast the technology is moving and how uncertain its social implications are, this article attempts to give some early tentative thoughts on what ChatGPT might mean for bioethics. I will first argue that many bioethics issues raised by ChatGPT are similar to those raised by current medical AI - built into devices, decision support tools, data analytics, etc. These include issues of data ownership, consent for data use, data representativeness and bias, and privacy. I describe how these familiar issues appear somewhat differently in the ChatGPT context, but much of the existing bioethical thinking on these issues provides a strong starting point. There are, however, a few "new-ish" issues I highlight - by new-ish I mean issues that while perhaps not truly new seem much more important for it than other forms of medical AI. These include issues about informed consent and the right to know we are dealing with an AI, the problem of medical deepfakes, the risk of oligopoly and inequitable access related to foundational models, environmental effects, and on the positive side opportunities for the democratization of knowledge and empowering patients. I also discuss how races towards dominance (between large companies and between the U.S. and geopolitical rivals like China) risk sidelining ethics.
Challenges of implementing computer-aided diagnostic models for neuroimages in a clinical setting
Authors: Matthew J. Leming, Esther E. Bron, Rose Bruffaerts, Yangming Ou, Juan Eugenio Iglesias, Randy L. Gollub, Hyungsoon Im
Journal: npj Digital Medicine (2023)

Abstract Advances in artificial intelligence have cultivated a strong interest in developing and validating the clinical utilities of computer-aided diagnostic models. Machine learning for diagnostic neuroimaging has often been applied to detect psychological and neurological disorders, typically on small-scale datasets or data collected in a research setting. With the collection and collation of an ever-growing number of public datasets that researchers can freely access, much work has been done in adapting machine learning models to classify these neuroimages by diseases such as Alzheimer’s, ADHD, autism, bipolar disorder, and so on. These studies often come with the promise of being implemented clinically, but despite intense interest in this topic in the laboratory, limited progress has been made in clinical implementation. In this review, we analyze challenges specific to the clinical implementation of diagnostic AI models for neuroimaging data, looking at the differences between laboratory and clinical settings, the inherent limitations of diagnostic AI, and the different incentives and skill sets between research institutions, technology companies, and hospitals. These complexities need to be recognized in the translation of diagnostic AI for neuroimaging from the laboratory to the clinic.
3D Elastomeric Stent Functionalized with Antioxidative and Perivascular Tissue Regenerative Activities Ameliorated PVT Deprivation‐Induced Vein Graft Failure
Authors: Yinggang Wang, Mingdi Fu, Weiwei Xiao, Yajing Zhao, Pingping Yuan, Xinchi Zhang, Wei Wu
Journal: Advanced Healthcare Materials (2023)

Clinically, arterial injuries are always accompanied with perivascular tissue damage, which may contribute to high failure rate of vein grafts due to intimal hyperplasia and acute thrombosis. In this study, a "perivascular tissue (PVT) deprivation" animal model is constructed to mimic clinical scenarios and identify the contribution of arterial PVT to the success of vein grafts. Proteomics analysis suggests that depriving PVT may exacerbate reactive oxygen species (ROS)-induced endothelial apoptosis by up-regulating inflammation response and oxidative stress. Locally administering metformin on vein grafts through 3D-printed external stent (PGS-PCL) shows antioxidative and anti-inflammatory properties to protect cells from ROS invasion, thereafter decreasing acute thrombosis. Moreover, metformin induce rapid regeneration of perivascular adipose tissue in recipient regions, which improves patency by inhibiting intimal hyperplasia. Proteomics, western blot, and in vitro blocking tests reveal that metformin resists endothelial apoptosis through AMPK/mTOR and NFκB signaling pathways. To conclude, PVT deprivation exacerbates inflammatory response and oxidative stress in vein grafts bridging arterial circulation. Metformin-loaded stent ameliorates "PVT damage" related vein graft failure, and enhances patency of through resisting endothelial apoptosis and regenerating arterial PVAT, offering a promising avenue to improve the success of vein grafts in clinic.
A Positive Distress Screen…Now What? An Updated Call for Integrated Psychosocial Care
Authors: Phoebe A. Tsao, Jesse R. Fann, Andrea L. Nevedal, Lindsey E. Bloor, Sarah L. Krein, Megan E.V. Caram
Journal: Journal of Clinical Oncology (2023)

How can we move collaborative care from evidence-based practice to everyday practice for those living with cancer and distress?
Competency assessment: a journey of lifelong learning
Authors: Arjun D. Koch
Journal: Endoscopy (2023)

Awareness of quality during training in endoscopy has increased tremendously over past decades and this is mainly attributable to the fact that we are moving away from minimum threshold numbers as surrogate markers of competence. Our focus has shifted to procedural competency, which is reached when a trainee can independently complete, successfully and repeatedly, all tasks that are required for a specific type of procedure. This is the point where certification can be obtained and independent practice can commence.
Endoscopic ultrasound-guided placement of fiducial markers for stereotactic body radiation therapy of pancreatic metastases from renal cell carcinoma
Authors: Marcin Polkowski, Konrad Pawlewicz, Krzysztof Skoczylas, Ewa Wrońska, Małgorzata Lenarcik, Jarosław Reguła
Journal: Endoscopy (2023)

Isolated pancreatic metastases from renal cell carcinoma (RCC) have traditionally been treated with surgery or systemic therapy [1]. More recently, focal therapies such as endoscopic ultrasound (EUS)-guided radiofrequency ablation or stereotactic body radiation therapy (SBRT) have been reported in selected patients [2] [3] [4]. SBRT uses precision technology to accurately deliver high doses of radiation in a few treatment fractions to the tumor volume, while sparing the surrounding healthy tissues. Many SBRT protocols require the placement of fiducial markers in or near the tumor to facilitate accurate targeting [4] [5]. Here we report EUS-guided fiducial placement for SBRT of pancreatic metastases in a 75-year-old woman with a history of left nephrectomy for RCC 20 years previously and a recent finding of two hypervascular pancreatic tumors on computed tomography (CT) scanning.
Neointima abating and endothelium preserving — An adventitia-localized nanoformulation to inhibit the epigenetic writer DOT1L
Authors: Takuro Shirasu, Nisakorn Yodsanit, Jing Li, Yitao Huang, Xiujie Xie, Runze Tang, Qingwei Wang, Mengxue Zhang, Go Urabe, Amy Webb, Yuyuan Wang, Xiuxiu Wang, Ruosen Xie, Bowen Wang, K. Craig Kent, Shaoqin Gong, Lian-Wang Guo
Journal: Biomaterials (2023)
Mortality associated with third-generation cephalosporin resistance in Enterobacterales bloodstream infections at eight sub-Saharan African hospitals (MBIRA): a prospective cohort study
Authors: Alexander M Aiken, Andrea M Rehman, Marlieke E A de Kraker, Lola Madrid, Meron Kebede, Appiah-Korang Labi, Noah Obeng-Nkrumah, Brian Nyamwaya, Eunice Kagucia, Derek Cocker, Kondwani Kawaza, Rebecca Lester, Kenneth C Iregbu, Nubwa Medugu, Philip I Nwajiobi-Princewill, Angela Dramowski, Tolbert Sonda, Asia Hemed, Sombo Fwoloshi, David Ojok, J Anthony G Scott, Andrew Whitelaw, Jabir Aliye, Nega Assefa, Dumessa Edessa, Joseph Oundo, Mulu Berihun, Thomas Dankwah, Mary M Osei, Maud Fandoh, Margaret Gakpo, Caroline Mulunda, Benedict Mvera, Mabvuto Chimenya, Nicholas Feasey, Jane Mallewa, Khadija Abdulraheem, Tobechi A Akujobi, Chinelo H Okonkwo, Luzell Britz, André N H Bulbula, Aaqilah Fataar, Blandina T Mmbaga, Neema Ng'unda, Uchizi Chirwa, Nyambe Kakula, Charles Mutemba, Ruth Nakazwe
Journal: The Lancet Infectious Diseases (2023)

Bacteria of the order Enterobacterales are common pathogens causing bloodstream infections in sub-Saharan Africa and are frequently resistant to third-generation cephalosporin antibiotics. Although third-generation cephalosporin resistance is believed to lead to adverse outcomes, this relationship is difficult to quantify and has rarely been studied in this region. We aimed to measure the effects associated with resistance to third-generation cephalosporins in hospitalised patients with Enterobacterales bloodstream infection in Africa.
Simian malaria: a narrative review on emergence, epidemiology and threat to global malaria elimination
Authors: Kimberly M Fornace, Gabriel Zorello Laporta, Indra Vythilingham, Tock Hing Chua, Kamruddin Ahmed, Nantha K Jeyaprakasam, Ana Maria Ribeiro de Castro Duarte, Amirah Amir, Wei Kit Phang, Chris Drakeley, Maria Anice M Sallum, Yee Ling Lau
Journal: The Lancet Infectious Diseases (2023)
Brain structure and phenotypic profile of superagers compared with age-matched older adults: a longitudinal analysis from the Vallecas Project
Authors: Marta Garo-Pascual, Christian Gaser, Linda Zhang, Jussi Tohka, Miguel Medina, Bryan A Strange
Journal: The Lancet Healthy Longevity (2023)

Cognitive abilities, particularly memory, normally decline with age. However, some individuals, often designated as superagers, can reach late life with the memory function of individuals 30 years younger. We aimed to characterise the brain structure of superagers and identify demographic, lifestyle, and clinical factors associated with this phenotype.
Carcinogenicity of aspartame, methyleugenol, and isoeugenol
Authors: Elio Riboli, Frederick A Beland, Dirk W Lachenmeier, M Matilde Marques, David H Phillips, Eva Schernhammer, Abdul Afghan, Ricardo Assunção, Giovanna Caderni, J Christopher Corton, Gisela de Aragão Umbuzeiro, Daphne de Jong, Melanie Deschasaux-Tanguy, Allison Hodge, Junko Ishihara, Dan D Levy, Daniele Mandrioli, Marjorie L McCullough, Sarah A McNaughton, Takeshi Morita, Anne P Nugent, Kumiko Ogawa, Arun R Pandiri, Consolato M Sergi, Mathilde Touvier, Luoping Zhang, Lamia Benbrahim-Tallaa, Shirisha Chittiboyina, Danila Cuomo, Nathan L DeBono, Charlotte Debras, Aline de Conti, Fatiha El Ghissassi, Emma Fontvieille, Rhea Harewood, John Kaldor, Heidi Mattock, Elisa Pasqual, Gabrielle Rigutto, Hannah Simba, Eero Suonio, Susana Viegas, Roland Wedekind, Mary K Schubauer-Berigan, Federica Madia
Journal: The Lancet Oncology (2023)
A dysfunctional miR-1-TRPS1-MYOG axis drives ERMS by suppressing terminal myogenic differentiation
Authors: Sören S. Hüttner, Henriette Henze, Dana Elster, Philipp Koch, Ursula Anderer, Björn von Eyss, Julia von Maltzahn
Journal: Molecular Therapy (2023)

Rhabdomyosarcoma is the most common pediatric soft tissue tumor, comprising two major subtypes: the PAX3/7-FOXO1 fusion-negative embryonal and the PAX3/7-FOXO1 fusion-positive alveolar subtype. Here, we demonstrate that the expression levels of the transcriptional repressor TRPS1 are specifically enhanced in the embryonal subtype, resulting in impaired terminal myogenic differentiation and tumor growth. During normal myogenesis, expression levels of TRPS1 have to decrease to allow myogenic progression, as demonstrated by overexpression of TRPS1 in myoblasts impairing myotube formation. Consequentially, myogenic differentiation in embryonal rhabdomyosarcoma in vitro as well as in vivo can be achieved by reducing TRPS1 levels. Furthermore, we show that TRPS1 levels in RD cells, the bona fide model cell line for embryonal rhabdomyosarcoma, are regulated by miR-1 and that TRPS1 and MYOD1 share common genomic binding sites. The myogenin (MYOG) promoter is one of the critical targets of TRPS1 and MYOD1; we demonstrate that TRPS1 restricts MYOG expression and thereby inhibits terminal myogenic differentiation. Therefore, reduction of TRPS1 levels in embryonal rhabdomyosarcoma might be a therapeutic approach to drive embryonal rhabdomyosarcoma cells into myogenic differentiation, thereby generating postmitotic myotubes.
Automated detection and segmentation of pulmonary embolisms on computed tomography pulmonary angiography (CTPA) using deep learning but without manual outlining
Authors: Jiantao Pu, Naciye Sinem Gezer, Shangsi Ren, Aylin Ozgen Alpaydin, Emre Ruhat Avci, Michael G. Risbano, Belinda Rivera-Lebron, Stephen Yu-Wah Chan, Joseph K. Leader
Journal: Medical Image Analysis (2023)